Patient Questionnaire
To help us improve our services, please complete this short questionnaire so that we can make things even better at your next visit. Please choose the answer which matches your view. This is strictly anonymous and confidential
* Required
1. Waiting time in the surgery to see dentist for your appointment
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Very satisfied
Satisfied
Dissatisfied
This is a required question
2. Staff welcoming and respecting
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Very satisfied
Satisfied
Dissatisfied
This is a required question
3. Dentist or hygienist ability to listen to you
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Very satisfied
Satisfied
Dissatisfied
This is a required question
4. Your options explained to you
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Very satisfied
Satisfied
Dissatisfied
This is a required question
5. The cost explained to you
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Very satisfied
Satisfied
Dissatisfied
This is a required question
6. You were informed about the status of your oral health?
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Very satisfied
Satisfied
Dissatisfied
This is a required question
7. Your questions being answered
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Very satisfied
Satisfied
Dissatisfied
This is a required question
8. We obtained consent from you
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Very satisfied
Satisfied
Dissatisfied
This is a required question
8a. Cleanliness of the practice
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Very satisfied
Satisfied
Dissatisfied
This is a required question
9. Did you see dentist or hygienist?
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Dentist
Hygienist
This is a required question
10. Would you recommend us to your family and friends
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Yes I would
If surgery do some improvments I will recommend your surgery to my family and friends
No I would not
This is a required question
11. Who did you see?
*
This is a required question
12. Thinking about your entire visit, what stands out as most positive?
*
This is a required question
13. What thing could make your visit better?
*
This is a required question
14. Any comments or suggestion you wish to make?
*
This is a required question
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